Video laryngoscope with detachable light and image guides

ABSTRACT

A combination laryngoscope and video display for providing images of the area ahead of the laryngoscope to facilitate insertion without damaging the surrounding tissue; the laryngoscope having a detachable blade and a rigid, detachable light and image guide attachment device for providing illuminating light ahead of the blade and for detecting the reflected light.

This is a CIP of 09/418,542, filed Oct. 14, 1999, now U.S. Pat. No.6,494,826.

FIELD OF THE INVENTION

The invention relates to an intubating video laryngoscope with a rigid,detachably connectable light guiding system and video guiding system.

BACKGROUND OF THE INVENTION

In the United States, approximately 10 million patients are operated onand anesthetized each year. While anesthetized, the patient's breathingfunctions are temporarily disabled. Ventilation is therefore supplied tothe patient by the anesthesiologist during the procedure.

Ventilation is provided through an endotracheal tube. This tube isinserted into the trachea, and it is closed against the wall of thetrachea by an inflatable cuff. The insertion of this tube involves risksthat the anesthesiologist seeks to avoid or at least minimize. It isestimated that between one in 6,000 to one in 8,000 general anesthesiaprocedures result in death. There are of course many causes but of theseit is estimated that about one third of them are caused by theintubation procedure.

The foremost obstacles encountered by the anesthesiologist include; theremoteness of the location where the tube is to be positioned, theconsequent restriction of view as the tube is inserted, variations andanomalies in the anatomy of the patients, an uncomfortable and unnaturalposition for the anesthesiologist while holding the instrument, thepotential need to change blades during the procedure, and the necessityfor rapid intubation.

It should be noted that when the tube is inserted, the patient is asleephyperoxygenated and then paralyzed for the procedure, and therefore notbreathing. In addition, the ventilator is not yet in operation. Thisgives the anesthesiologist only about two minutes in which to intubatethe patient, inflate the cuff, and start ventilation. If he is delayedbecause of unsuccessful attempts, he must stop, apply a ventilation maskto the patient, supply oxygen for a time through the mask, remove themask, adjust medication if necessary, and then start over again. Thisdelays the operation and extends the patient's time under anesthesia.This extension of time while under anesthesia may have very seriousconsequences, especially for elderly patients.

With the advent of endoscopic equipment and small cameras,instrumentation has been improved to the extent that it can enableviewing of the cords and larynx on a video screen thereby facilitatingthe intubation of the patient in a relatively quick and safe manner.However, conventional instrumentation may be further improved such thatthe laryngoscope is easier to use, thereby reducing the time involvedfor instance, to change blades or attach and detach peripheralcomponents.

Endoscopes are now widely used in minimally invasive surgery. Endoscopestypically contain a light guiding system, usually in the form of fiberoptic cables, in order to bring light to the surgical area. The lightguiding system typically extends through the handle of the laryngoscopeand through a guide tube located in the blade so as to position thelight guiding system to illuminate the area ahead of the blade.Endoscopes also typically contain an image guiding system, for examplein the form of a rigid rod lens system, arranged in the shaft of theendoscope. The image guiding system can also be configured as anordered, flexible fiber optic bundle. The image guiding system isutilized to transmit reflected light from the area ahead of the blade toa camera. The camera, attached at the proximal end of the endoscope,usually contains a CCD (charge coupled device) sensor, in the form of alight-sensitive chip that converts the optical signals into electricalsignals that are conveyed from the image-sensing camera module to aremotely located image processing system. The image guide typicallyextends from the distal end of the blade through the guide tube and thenthrough the handle of the laryngoscope.

Typically, the combination light guiding system and image guiding systemare permanently attached to the handle and are continuous, extendingfrom the distal end of the blade, through the handle of the laryngoscopeand to the camera for the image guiding system, and to the light sourcefor the light guiding system. Therefore, the light guiding system andimage guiding system extending from the handle of the laryngoscope forinsertion into the guide tube of the blade typically comprise flexiblecoherent fiber optic bundles. However, when changing blades, the bundlemust be carefully inserted or withdrawn from the opening of the guidetube at the proximal end of the blade. This may take an unacceptableamount time for the physician to thread the bundle into the tube if theblade must be changed in the middle of the intubation process.

The light and image guiding systems have typically been permanentlyattached to the handle to ensure the system will reliably transmit theilluminating light and reflected images. To utilize a detachablyconnectable light and image guiding system, the attachment means wouldhave to rigidly hold the member in place such that the light and imageguiding systems did not become misaligned. In addition, the attachmentmeans must be easy and quick to operate, making it possible to performthe coupling procedure with as little close attention as possible, butnevertheless reliably. Provision must therefore be made for the couplingelements to be keyed to each other so that the coupling cannot beincorrectly joined and so that close attention by the operation is notrequired.

In addition, the flexible bundles may easily be damaged and will wearover time, degrading or rendering the system inoperable. As a visualinspection of the device often will not indicate whether the bundles aredamaged, it is conceivable that a physician may obtain a damaged ormalfunctioning laryngoscope not realizing that it is damaged. The timeinvolved with determining that the instrument is malfunctioning,withdrawing it, finding another laryngoscope, and then intubating thepatient may have severe adverse effects upon the patient underanesthesia.

Further, laryngoscopes, as with most medical equipment, must besterilized after use. Because the light and image guiding systems arepermanently attached to the handle, they are exposed to extremely hightemperatures, which also cause wear and/or failure of the flexiblebundles. Also, because the light and image guiding systems are subjectedto the sterilization process with the handle and blades, the handle mustbe hermetically sealed which may greatly add to the cost inmanufacturing such a device.

It is therefore desired to provide an improved video laryngoscope thatis easy to use and will facilitate the quick removal and reattachment ofa blade, the light guiding system and the image guiding system.

It is also desired to provide an improved video laryngoscope with ahighly durable light guiding system and image guiding system.

It is further desired to provide an improved video laryngoscope thatwill reduce the costs associated with the manufacture of thelaryngoscope.

It is also desired to provide an improved video laryngoscope having acoupling system that will reliably connect the laryngoscope handle witha light and image guiding attachment while requiring a minimal amount ofattention from the user to attach or detach.

SUMMARY OF THE INVENTION

These and other objectives are achieved by providing a videolaryngoscope having a coupling mechanism that rigidly connects thelaryngoscope handle to the light and image guiding attachment.

Accordingly, the coupling mechanism is provided with a first cylindricalstem of specific diameter and specific length, in whose interior isreceived a proximal end segment of the light guiding system, and whichprojects from one coupling end of the light and image guiding attachmentin the coupling direction. Further, a second cylindrical stem isprovided whose length and diameter are greater than the length anddiameter of the first stem, having a proximal end segment of the imageguiding system being received in the interior of the second stem, andwhich projects from one coupling end of the light and image guidingattachment in the coupling direction. The second stem coacts with aninterlock system arranged in the laryngoscope handle forming a rigidmechanical coupling, the first and second stems extending at a distancenext to one another. Complementary receptacles corresponding to the twostems, into which the stems penetrate, are provided in the laryngoscopehandle. The base of the receptacle into which the second stem penetratesis optically connected to the camera, and the receptacle in which theshorter first stem is receivable is connected to the light source.

The mechanical, light-guiding, and image-guiding coupling isaccomplished by way of a single simple linear displacement operation, inwhich specifically the two stems are pushed into the correspondingreceptacles of the laryngoscope handle. Because one of the two stems isthicker and longer than the other, incorrect (i.e. reversed) insertionis not possible. Because the thicker stem is also simultaneously thelonger one, it is possible, without undue attention, to feel for thecorrespondingly larger receptacle on the camera module with this thickerand longer stem, and then to close the coupling with an insertionmovement. Incorrect attachment is thus no longer possible, since thethicker and longer stem cannot be attached to the smaller-diameterreceptacle for the smaller and shorter stem.

The mechanical interlock or coupling is affected simultaneously withthis insertion. Because the larger stem is also the longer stem, and itcarries the image guiding system, the image-guiding connection occurs atan axial spacing from the light-guiding connection. This feature has theadvantage that any stray light that might emerge from the lightconnection cannot directly come into contact with the image-guidingconnecting point located at an axial distance therefrom. Thedisadvantages of connecting image and light at the same level, or those,for example, of a coaxial arrangement, are thus eliminated.

Because the coupling mechanism is keyed, the physician can therefore,for example, sense the laryngoscope handle and its precise graspedposition in the coupling region with one hand, and with the other handcan easily sense the light and image guiding attachment and its graspedposition as well, so that the two elements to be coupled can then beinserted into one another without visual contact. This greatlyfacilitates handling, especially when, during a procedure, one bladeneeds to be quickly exchanged for another, such that the light and imageguiding attachment must be removed and re-attached along with the blade.

An interlock system is displaceable transversely to the couplingdirection that can be engaged into a recess on the second stem. Thisfeature has the advantage that in order to close and/or release thecoupling, the locking element is displaced transversely to the couplingdirection and is engaged into or disengaged from the recess on thesecond stem. These are all procedures that can be controlled, withoutvisual contact, with the fingers of one hand; the snapping of thelocking element into and out of the recess on the stem indicates to theoperator whether the coupling is closed or open. If the locking elementneeds to be pushed into the recess, for example to close the coupling,this can be done by simply inserting the stems into their correspondingreceptacles; precise locking can be ascertained by an audible sound thatthe locking element has been engaged. The locking element may comprisefor instance, ball catches, hooks, snap lugs, or the like.

The locking element is acted upon by the force of a spring, and radiallyprojects into the receptacle for the second stem. This is advantageousbecause, the force of the spring presses the locking element into adefined position, and the coupling may be disengaged by the applicationof a force opposite the coupling direction, namely withdrawing the stemsfrom their respective receptacles. These are all procedures that can besensed and controlled with the hand's sense of touch, so that no visualattention or observation is necessary when closing and opening thecoupling.

The second stem may have a conical segment at the end that is followedby an undercut. The conical segment constitutes an insertion aid uponinsertion of the stem into the receptacle, so that exact insertion isguaranteed with even approximate placement. At the same time, theconical surface can be utilized to displace the locking element radiallyupon insertion.

In addition, the undercut in the second stem may be configured as anannular groove. This forms a relatively large engagement surface withthe locking element, so that the mechanical forces acting on thecoupling will be dispersed over the entire area, which contributes tomechanical stability and less wear through use.

In addition, the first and second stems along with the receptaclesreceiving them each have a window. The windows thereby provide a sealedclosure for the light and image guiding systems.

The light and image guiding attachment is preferably provided with astainless steel outer casing, or some other suitable rigid enclosure,for protecting the light and image guides. As the light and imageguiding attachment is detachable from the handle, the handle does nothave to be hermetically sealed for sterilization. Rather, only the lightand image guiding attachment need be subjected to sterilization.

Accordingly, in one advantageous embodiment of the present invention, anintubating laryngoscope system is provided comprising a blade, a handleand a joinder for detachably connecting the handle to the blade. Thesystem also includes a two-stem receptacle connector, a first lightguide for transmitting illuminating light that is terminated in thetwo-stem receptacle connector, an first image guide for transmittingreflected light that is also terminated in the two-stem receptacleconnector, and a light and image guiding attachment, detachablyconnectable to the handle. The light and image guiding attachmentincludes a two-stem plug connector designed to mate with the two-stemreceptacle connector, a second light guide for transmitting illuminatinglight and terminated in the two-stem plug connector, a second imageguide for transmitting reflected light and terminated in the two-stemplug connector, and a substantially rigid outer casing for encasing thesecond light guide and the second image guide.

In another advantageous embodiment of the present invention, anintubating laryngoscope system is provided comprising a handle havingfirst light guide and a first image guide, a blade, a joinder fordetachably connecting the handle to the blade, and a receptacleconnector for terminating the first light guide and the first imageguide. The system further includes a light and image guiding attachmentthat is detachably connectable to the handle and has a plug connectorwith a first stem and a second stem, a second light guide terminated inthe first stem, a second image guide terminated in the second stem, anda substantially rigid outer casing for encasing the second light guideand the second image guide.

In yet another advantageous embodiment of the present invention, amethod for providing an intubating laryngoscope system is disclosedincluding the steps of providing a handle having a first light guide anda first image guide, providing a blade, providing a receptacle connectorlocated in the handle, terminating the first light guide and the firstimage guide in the receptacle connector, and providing a rigid light andimage attachment that is detachably connectable to the handle. The lightand image attachment have a second light guide and a second image guidelocated therein and provide a plug connector at a proximal end of thelight and image attachment. The method further includes terminating thesecond light guide in the plug connector, terminating the second imageguide in the plug connector, detachably connecting the blade to thehandle, and detachably connecting the light and image attachment to thehandle such that the light and image attachment is rigidly attached tothe handle when in an engaged position.

In still another advantageous embodiment of the present invention, anintubating laryngoscope system is provided comprising a handle having afirst light guide and a second image guide, a blade connected to thehandle, a receptacle connector for terminating the first light guide andthe first image guide, and a substantially rigid light and image guidingattachment. The rigid light and image guiding attachment is detachablyconnectable to the handle, and has a plug connector receivable in thereceptacle connector, a second light guide terminated in the plugconnector, and a second image guide terminated in the plug connector. Inaddition, the first light guide and the first image guide are incommunication with the second light guide and the second image guiderespectively, via the receptacle and plug connectors.

It is understood that the features mentioned above and those yet to beexplained below can be used not only in the respective combinationsindicted, but also in other combinations or by themselves, withoutleaving the context of the present invention.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an illustration of the video laryngoscope with a curved bladeand the light and image guiding attachment engaged with the handle.

FIG. 2 is an illustration of a curved blade detached from the handle.

FIG. 3 is a perspective view of the handle depicting the housingcontaining the receptacles for the light and image guiding attachment.

FIG. 4 is an illustration of the curved light and image guidingattachment as detached from the handle.

FIG. 5 is a cross-sectional view of the housing containing thereceptacles for the light and image guiding attachment.

FIG. 6 is a cross-sectional view of the coupling element utilized inconjunction with the light and image guiding attachment.

FIG. 7 is an illustration of the video laryngoscope with a straightblade and the light and image guiding attachment engaged with thehandle.

DETAILED DESCRIPTION OF THE DRAWINGS

The video laryngoscope 10, along with the attached blade 12 and lightand image guiding attachment 14 is illustrated in FIG. 1. The videolaryngoscope 10 is comprised of three main parts; the blade 12, thelight and image guiding attachment 14, and the handle 16.

The handle 16 is typically cylindrical with a knurled outer surface 18thereby facilitating a secure gripping surface. As is shown in FIG. 1,the handle 16 is detachably joined to a blade 12, which in this instanceis curved, by a hinge-type joinder 20.

The hinge-type joinder 20 includes a pair of conventional hinge socket22 and connector 24 respectively mounted to the lower end of the handle16 and to a proximal end 34 of the blade 12. Socket 22 further includesa crossbar 26. Connector 24 includes a hook 28 in a block 30 that fitsinto socket 22 and is more clearly seen in FIG. 2. The hook 28 engagesthe crossbar 26, and the handle 16 is rotated 90 degrees so that theblade will be rigidly held to the handle 16. This is a common hinge-typejoinder 20 used in this type of instrumentation and is useful for allblade forms, of which the two illustrated forms are merely examples. Aball detent 32 detachably retains the handle 16 and blade 12 togetherand erect in the assembled configuration. The assembled instrument isrigid during the procedure.

Blade 12 has a distal end 36 which may be smoothed by a bulb-like edge38. It has a curved top surface 40 extending from the distal end 38toward the proximal end 34. This top surface 40 is used to elevate thetongue and permit the visualization of the vocal cords beneath it.

Referring back to FIGS. 1 and 2, blade 12 additionally includes anattachment hole 42 at the distal end 36 of the blade 12. The attachmenthole 42 is designed to receive a distal end 43 of light and imageguiding attachment 14 so and to provide additional support to rigidlyhold it in position and align the distal end 43 of the light and imageguiding attachment 14 with the distal end 36 of the blade 12.

The handle is provided with means for obtaining an image of the fieldlocated beyond the tip of the blade 12, and for providing illuminatinglight to that field. In one embodiment, a camera (not shown) is mountedin a chamber inside the handle 16.

An image cable 44 to conduct image data from the camera exits from thetop of the handle 16. It is connected to a video set (not shown), whichprovides data for an image on a video screen (not shown), forobservation by the anesthesiologist. In addition, in some embodiments anillumination cable 46 conducts illuminating light to the handle 16.

In one embodiment, light for illumination of the field ahead of thedistal end 36 of blade 12 is obtained from a separate light source (notshown) that can be placed in any convenient nearby location. Anillumination cable 46, which may comprise a fiber optic bundle extendsfrom the light source (not shown) to the handle 16. The illuminationcable 46 need not be coherent, because it does not transmit an image—ittransmits only illuminating light. Both the image cable 44 and theillumination cable 46 may enter the top of handle 16.

The actual construction of image cable 44 depends on the arrangement ofthe camera. In a preferred embodiment, the camera (not shown),customarily a CCD chip, is mounted in the handle 16. In this case, theimage cable 44 comprises a electrical cable, which extends from thecamera output (not shown), out the top of the handle and to a videodisplay (not shown). The image guide extending through the light andimage guiding attachment 14, through the handle 16 and terminating atthe camera input (not shown) comprises a bundle of coherent fiber opticcables to transmit the reflected light from the area ahead of the blade12 to the camera (not shown).

In an alternative embodiment, the camera (not shown) may be locatedremotely from the video laryngoscope 10. In this case, the image guidingcable 44 would comprise a bundle of coherent fiber optic cablesextending through the light and image guiding attachment 14, through thehandle 16 and terminating at the camera, which is located remotely fromthe video laryngoscope 10.

The light guiding system receptacle 52 and the image guiding systemreceptacle 48 are both contained in housing 50 as illustrated in FIGS. 3and 5. The light guiding system receptacle 52 has an inner surface 54defining a cross-sectional diameter of the receptacle openingcorresponding to a diameter of a first stem 56 shown in FIGS. 4, 5 and6. Further, the image guiding system receptacle 48 has an inner surface58 defining a cross-sectional diameter of the receptacle openingcorresponding to a diameter of a second stem 60 also shown in FIGS. 4, 5and 6.

FIG. 4 shows the light and image guiding attachment 14 detached from thehandle 16. The light and image guiding attachment 14 comprises a rigidcurved shaft 62 and a coupling element 64. The coupling element 64further comprises a first stem 56 and a second stem 60 along with ahousing 66. The rigid curved shaft 62 is preferably made of stainlesssteel but may be manufactured on any rigid non-corroding material. Therigid curved shaft contains both, the light guiding cable 46 fortransmitting illuminating light ahead of the distal end 36 of the blade12, and the image guiding cable 44 for receiving the reflected light andtransmitting it to the camera (not shown) located in the handle 16. Therigid curved shaft 62 also has a window 66, located at the distal end68, which acts to seal the light and image guiding attachment 14.

Referring back to the coupling element 64, an approximately cylindricalsecond stem 60, protrudes at one coupling end 70 of housing 66. Thelength and inside diameter of image guiding system receptacle 48 areselected so that second stem 60 can be received snugly therein. A window72 is provided at the end of the second stem 60 to provide a seal forthe image guiding cable 44. A first approximately cylindrical stem 56extends from one coupling end 70 of housing 66 parallel to second stem60. The first stem 56 is smaller in diameter and length than the secondstem 60. Also window 74 is provided at the end of the first stem 56 toprovide a seal for the light guiding cable 46.

Second stem 60, comprises a cylindrical segment 76, and annular groove78, and a terminal conical segment 80. Both stems 56 and 60 extend in acoupling direction to mate with receptacles 52 and 48 respectively.

A locking element 82, displaceable radially with respect to the couplingdirection, is located in housing 50. Locking element 82 may beapproximately the shape of a two-tined fork that is bent inward in acircular shape at the outer end, the radius of curvature correspondingapproximately to the radius of curvature of image guiding systemreceptacle 48. The outer ends of locking element 82 project slightlyinto image guiding system receptacle 48 as shown in FIG. 5.

Conical segment 80 of second stem 60 thereby encounters the ends oflocking element 82 projecting into image guiding system receptacle 48and displaces them radially outward.

When second stem 60 has been pushed into image guiding system receptacle48 to the point that the ends of locking element 82 come to rest at thelevel of annular groove 78, they snap into annular groove 78.

In this position the coupling is now closed, i.e. coupling system 10 iscoupled and mechanically interlocked. In this state, window 72 of secondstem 60 and window 84 in the base of image guiding system receptacle 48lie congruently with one another, thus creating an image-guidingcoupling. Window 74 of first stem 56 comes to rest in front of window 86of light guiding system receptacle 52, so that a light-guiding couplingis also created.

All that is necessary to release the coupling is withdraw the light andimage guiding attachment outward with enough force to overcome thelocking element 82 as engaged in annular groove 78.

It is now seen that joining the blade 12 and the light and image guidingattachment 14 to the handle 16 is a swift process. The portions of thehinge-type joinder 20 are engaged and the handle 16 is then rotated,locking the blade 12 into place. To attach the light and image guidingattachment 14 one fits the distal end 43 of the light and image guidingattachment 14 through the attachment hole 42 at the distal end 36 of theblade 12 and then engages stems 56 and 60 of the coupling element 64with receptacles 52 and 48 in a coupling direction. Removal isquick—merely withdraw the light and image guiding attachment 14 androtate the handle 16 to release the blade 12, and pull the handle 16away from the blade 12. Removal and replacement are very simple.

Having a detachably connectable light and image guiding attachment 14means that the light and image guiding attachment 14 may be detachedfrom the handle 16 for sterilization. This further means that the handle16 must no longer be hermetically sealed for sterilization. Thisprovides the distinct advantage of lowering the cost involved withmanufacturing the handle 16 as now they do not have to be subjected tothe extremely high temperatures associated with the sterilizationprocess. Further, any electronic components located in the handle 16will no longer be subjected to the high temperatures of sterilization,which could prematurely age or damage them.

Instead of the camera and illumination arrangements already described,there are other alternatives, which can be used in any combination.

For example, instead of employing a separate light source (not shown), abattery and light bulb may be contained in the handle 16, and the lightfrom this bulb focused onto light guiding cable 46. This eliminates theneed for a fiber optic bundle from a light source, and also eliminatesthe separate light source itself.

The video laryngoscope 10, along with the attached blade 110 and lightand image guiding attachment 112 is illustrated in FIG. 7. The videolaryngoscope 10 is again comprised of three main parts; the blade 110,the light and image guiding attachment 112, and the handle 16.

The blade 12 illustrated in FIGS. 1 and 2 is a curved blade 12, which isused to elevate the patients tongue in some circumstances. It is thewell-known McIntosh blade 12. However, a different blade 110 for adifferent anatomical configuration is a straight blade 110 adapted foruse in other circumstances. It is illustrated in FIG. 7. This is thewell-known Foregger-Magill blade 110. These are the two most commonblade shapes. Their configuration is not a limitation on the invention.The configurations of this handle 16 and these blades are completelyconventional. They are standard equipment utilized by anesthesiologiststrained to intubate the trachea. An advantage of this invention is thatit does not require any additional training or re-training ofanesthesiologists who have used these well known blades and willutilized them in the future.

The curved blade 12 illustrated in FIGS. 1 and 2 differs from thestraight blade 110 illustrated in FIG. 7 only by its shape. The straightblade 110 in FIG. 7 has a straight upper surface 114 instead of a curvedsurface 40 for use when such a surface is preferred for lifting thetongue of the individual patient. In all cases the objective is to liftthe tongue to permit visualization of the vocal cords and to enable theendotracheal tube to be accurately placed without harming surroundingtissue in the process.

In addition, the light and image guiding attachment 116 as shown in FIG.7, differs from the light and image guiding attachment 14 as depicted inFIGS. 1 and 4 only by its shape. The light and image guiding attachment14 is curved to match the curved blade 12 as depicted in FIGS. 1 and 4,whereas the light and image guiding attachment 116 is a straighterconfiguration corresponding to the straight blade 110 as shown in FIG.7.

As the handle 16, the blade 110 and the light and image guidingattachment 112 operate in the same manner as the aforedescribed curvedblade 12 and light and image guiding attachment 14, they will not bere-described.

Although the invention has been described with reference to a particulararrangement of parts, features and the like, these are not intended toexhaust all possible arrangements or features, and indeed many othermodifications and variations will be ascertainable to those of skill inthe art.

1. An intubating laryngoscope system comprising: a blade; a handleincluding: a joinder for detachably connecting said handle to saidblade; a two-stem receptacle connector; a first light guide fortransmitting illuminating light and terminated in the two-stemreceptacle connector; an first image guide for transmitting reflectedlight and terminated in the two-stem receptacle connector; and a lightand image guiding attachment, detachably connectable to said handle, thelight and image guiding attachment including: a two-stem plug connectordesigned to mate with the two-stem receptacle connector; a second lightguide for transmitting illuminating light and terminated in the two-stemplug connector; a second image guide for transmitting reflected lightand terminated in the two-stem plug connector; and a substantially rigidouter casing for encasing the second light guide and the second imageguide; wherein said first light guide and said first image guide are incommunication with said second light guide and said second image guiderespectively, via the receptacle and plug connectors when in an engagedposition.
 2. The system according to claim 1 wherein said two-stem plugconnector comprises a first stem and a second stem, the second stembeing larger in diameter and length than the first stem.
 3. The systemaccording to claim 2 wherein said two-stem receptacle connector and saidtwo-stem plug connector comprise a locking element to rigidly maintainthe connectors together when in an engaged position.
 4. The systemaccording to claim 3 wherein said locking element is displaceabletransversely to a direction of movement to engage the connectors, saidlocking element being engagable into a recess provided on a stem of saidtwo-stem plug connector.
 5. The system according to claim 4 such thatwhen the two-stem receptacle connector with the two-stem plug connectorare engaged there is an audible indication upon engagement.
 6. Thesystem according to claim 2 wherein the second stem has a conical endsection followed by an undercut.
 7. The system according to claim 6wherein the undercut is configured as an annular groove of the secondstem.
 8. The system according to claim 2 wherein the first and secondstems and said two-stem receptacle connector each have windows.
 9. Thesystem according to claim 1 wherein said handle is adapted to receivedan eyepiece.
 10. The system according to claim 1 in which said light andimage guiding attachment comprises stainless steel.
 11. The systemaccording to claim 1 in which said light guide is a fiber optic cable.12. The system according to claim 1 further comprising a light sourcethat includes a battery and bulb combination in said handle to provideilluminating light to said light guide.
 13. The system according toclaim 1 wherein said light and image guiding attachment furthercomprises an optically clear and transparent window for sealing a distalend of said light and image guide attachment.
 14. An intubatinglaryngoscope system comprising: a handle having first light guide and afirst image guide; a blade; a joinder for detachably connecting saidhandle to said blade; a receptacle connector, for terminating the firstlight guide and the first image guide; a light and image guidingattachment, detachably connectable to said handle, including: a plugconnector having a first stem and a second stem; a second light guideterminated in the first stem; a second image guide terminated in thesecond stem; and a substantially rigid outer casing for encasing thesecond light guide and the second image guide.
 15. The system accordingto claim 14 wherein said receptacle connector and said plug connectorcomprise a locking element to rigidly maintain the connectors togetherwhen in an engaged position.
 16. The system according to claim 15wherein said locking element is displaceable transversely to a directionof movement to engage the connectors, said locking element beingengagable into a recess provided on the second stem.
 17. The systemaccording to claim 16 such that when the receptacle connector with theplug connector are engaged there is an audible indication uponengagement.
 18. The system according to claim 16 wherein said secondstem has a conical end section followed by an undercut.
 19. The systemaccording to claim 17 wherein the undercut is configured as an annulargroove of the second stem.
 20. The system according to claim 14 whereinthe second stem and the receptacle connector receiving it each have anoptically clear transparent window.
 21. The system according to claim 14wherein said handle is adapted to received an eyepiece.
 22. The systemaccording to claim 14 in which said light and image guiding attachmentcomprises stainless steel.
 23. The system according to claim 22 in whichsaid light and image guiding attachment is closed at a distal end withan optically clear and transparent window.
 24. A method for providing anintubating laryngoscope system including the steps of: providing ahandle having a first light guide and a first image guide; providing ablade; providing a receptacle connector located in the handle;terminating the first light guide and the first image guide in thereceptacle connector; providing a rigid light and image attachment thatis detachably connectable to the handle, the light and image attachmenthaving a second light guide and a second image guide located therein;providing a plug connector at a proximal end of the light and imageattachment; terminating the second light guide in the plug connector;terminating the second image guide in the plug connector; detachablyconnecting the blade to the handle; and detachably connecting the lightand image attachment to the handle such that the first light guide andthe first image guide are in communication with the second light guideand the second image guide respectively, via the receptacle and plugconnectors when in an engaged position.
 25. The method of claim 24further comprising the step of providing a locking element for thereceptacle connector and the plug connector and rigidly maintaining themtogether when in an engaged position.
 26. The method of claim 25 furthercomprising the step of providing an audible indication when thereceptacle connector with the plug connector are fully engaged.
 27. Themethod of claim 24 further comprising the step of adapting said handleto receive an eyepiece.
 28. The method of claim 24 further comprisingthe step of providing an optically clear and transparent window at adistal end of the light and image attachment.
 29. An intubatinglaryngoscope system comprising: a handle having a first light guide anda first image guide; a blade connected to said handle; a receptacleconnector for terminating the first light guide and the first imageguide; and a substantially rigid light and image guiding attachment,detachably connectable to said handle, and including: a plug connectorinsertable into said receptacle connector; a second light guideterminated in the plug connector; a second image guide terminated in theplug connector; wherein said first light guide and said first imageguide are in communication with said second light guide and said secondimage guide respectively, via the receptacle and plug connectors when inan engaged position.
 30. An intubating laryngoscope system comprising: ahandle having a first light guide and a first image guide; a bladeconnectable to said handle; a first connector on said handle forterminating the first light guide and the first image guide; and a lightand image guide attachment, detachably connectable with said connector;and a second connector on said light and image guide attachment forterminating a second light guide and a second image guide; wherein saidfirst light guide and said first image guide are in communication withsaid second light guide and said second image guide respectively, viathe first and second connectors when in an engaged position.